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1.
BMC Surg ; 21(1): 92, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602167

RESUMO

BACKGROUND: Orbital solitary fibrous tumors (SFTs) are rare neoplasms. Recurrent, hypervascular, malignant variations of orbital SFTs have recently been noted and can present a surgical challenge. CASE PRESENTATION: We describe a case of a 53-year-old Chinese woman with a history of a resected orbital SFT. She presented with proptosis, limited eyeball movement, and visual loss in the right eye, suggestive of a recurrent SFT. Ocular examination with multimodal imaging revealed a large, nonpulsatile, noncompressible, hypervascular mass behind the eyeball. The patient underwent preoperative transarterial embolization of the main blood supply to the tumor in order to control intraoperative blood loss, followed by ocular enucleation to optimize exposure and enable complete resection of the tumor. Embolization of the right ophthalmic artery and the distal branch of the right internal maxillary artery caused an immediate, substantial reduction of vascular flow, which allowed us to enucleate the eyeball and resect the tumor with minimal blood loss and no complications. CONCLUSIONS: Our case is so far the first Chinese case of successful preoperative embolization of the main blood supply to a large, recurrent, hypervascular orbital SFT. This case also described a different surgical approach to achieve total removal of an orbital SFT without osteotomy.


Assuntos
Embolização Terapêutica , Recidiva Local de Neoplasia , Neoplasias Orbitárias , Cuidados Pré-Operatórios , Tumores Fibrosos Solitários , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Pessoa de Meia-Idade , Imagem Multimodal , Recidiva Local de Neoplasia/irrigação sanguínea , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/terapia , Neoplasias Orbitárias/irrigação sanguínea , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/terapia , Tumores Fibrosos Solitários/irrigação sanguínea , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/terapia , Resultado do Tratamento
3.
J Clin Neurosci ; 78: 128-134, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32507710

RESUMO

Spinal solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare mesenchymal malignancy. Radiographically, SFT/HPCs have a mutable appearance, with irregular borders, heterogeneous contrast enhancement, and variable but frequently hypointense T2 signal. We report a series of 5 neurosurgically managed spinal SFT/HPCs treated at our institution, with particular attention to 3 lesions demonstrating marked T2-hypointensity and differential diagnosis for the unusual finding of a "T2 dark" spinal lesion. Retrospective chart review of prospectively maintained surgical database, queried by diagnosis and site codes, 2002-2017. Retrospective radiographic review, with initial screening via keyword search of MR reports for "T2" and "hypointense." Four primary and one metastatic spinal SFT/HPCs were operatively treated during the study period (median follow-up 12 months; range 10-92). Three demonstrated marked T2 hypointensity on preoperative MRI, underwent primary resection-GTR in two, STR in one-and have remained progression-free on routine postoperative surveillance. Two patients with isointense lesions recurred within the follow-up period. Radiographic review identified a host of predominantly rare T2-hypointense lesions, including arteriovenous malformation, disk fragmentations, calcific arachnoiditis, calcifying pseudoneoplasm of the neuraxis, cavernoma, cord hemorrhage/acute blood, desmoid, granulocytic sarcoma, pigmented villonodular synovitis, Edheim-Chester, extramedullary hematopoiesis, IgG4-negative inflammatory pseudotumor, idiopathic hypertrophic pachymeningitis, B-cell lymphoma, primary melanoma neoplasm, melanotic schwannoma, meningioma, opacification of the posterior longitudinal ligament, osteoblastoma, osteochondroma, osteosarcoma, and synovial cyst. T2 hypointensity is associated with SFT/HPC, and may be an indicator relative indolence. "Dark" T2 spinal lesions are rare, with a narrow differential populated predominantly by rare entities.


Assuntos
Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/cirurgia , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/cirurgia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Estudos Prospectivos , Estudos Retrospectivos
4.
J Craniofac Surg ; 31(5): e491-e493, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32371717

RESUMO

Trans-oral robotic surgery (TORS) has become increasingly widespread for the head and neck surgery procedures. In this paper, the authors describe the first reported TORS in the management of a laryngeal solitary fibrous tumor (SFT). A 77-year-old woman suffered from progressive dysphonia lasting 2 years and occasional dyspnea. A submucosal mass of about 4 cm in diameter involving the left supraglottis and left aryepiglottic fold was detected during the flexible fibre-optic laryngeal examination. Magnetic resonance imaging revealed a solid, well-demarcated mass (36 × 25 mm), hyperintense with nonhomogeneous contrast enhancement in T2-weighted sequences. The lesion was successfully removed en bloc using the daVinci Xi system (Intuitive Surgical, Sunnyvale, CA) equipped with 3 robotic arms (1 3-dimensional endoscopic arm, 1 monopolar cautery, 1 bipolar Maryland forceps). The postoperative course was regular, and the endoscopic examination at 1 month showed normal laryngeal morphology and function. Trans-oral robotic surgery has proved to be a good alternative to conventional trans-oral approaches in the treatment of laryngeal SFT. The lesion was completely removed without intraoperative complications, and postoperative morbidity was minimized. Further comparative studies are recommended to define if TORS could become the gold standard for the surgical treatment of laryngeal SFTs.


Assuntos
Neoplasias Laríngeas/cirurgia , Tumores Fibrosos Solitários/cirurgia , Idoso , Endoscopia , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Procedimentos Cirúrgicos Robóticos , Tumores Fibrosos Solitários/diagnóstico por imagem
5.
Medicine (Baltimore) ; 99(17): e19783, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332621

RESUMO

INTRODUCTION: Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor that is most common in the pleura. However, according to previous studies, the SFT of the pancreas is extremely rare; only 20 cases have been reported so far. Here, we conduct a literature review and report the first case of atypical/malignant SFT of the pancreas with spleen vein invasion. PATIENT CONCERNS: The patient is a 61-year-old Chinese male who presented with 1 week of upper abdominal pain. Abdominal magnetic resonance imaging showed a huge mass (>10 cm) at the distal end of the pancreas, and the mass obstructing the splenic vein. DIAGNOSIS: Atypical/malignant SFT of the pancreas with splenic vein tumor thrombus. INTERVENTIONS: The patient underwent laparoscopic distal pancreatectomy with splenectomy procedure to achieve a radical resection, and did not undergo chemotherapy or radiotherapy. OUTCOMES: Abdominal computed tomography scans were performed at 1 and 4 months after resection, and no signs of recurrence or metastasis were found (. B).(Figure is included in full-text article.) CONCLUSION:: The clinical symptoms of atypical/malignant SFT of the pancreas with spleen vein invasion are not atypical, and imaging feature is lack of specificity. Preoperative diagnosis is difficult, and there is a potential for malignancy. However, due to the paucity of randomized control trials, there is no established, globally accepted treatment strategy, radiation therapy and chemotherapy regimens have not demonstrated global effectiveness, and no standardized treatments have been identified. Therefore, we recommend complete surgical resection and close clinical follow-up.


Assuntos
Pâncreas/anormalidades , Tumores Fibrosos Solitários/diagnóstico , Veia Esplênica/anormalidades , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Pâncreas/fisiopatologia , Pâncreas/cirurgia , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/cirurgia , Veia Esplênica/fisiopatologia , Veia Esplênica/cirurgia , Tomografia Computadorizada por Raios X/métodos
6.
Medicine (Baltimore) ; 99(5): e18992, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000437

RESUMO

INTRODUCTION: Malignant solitary fibrous tumor (MSFT) of the diaphragm is extremely rare, and to the best of our knowledge, only three cases have been reported in the past two decades. In all these cases, the diaphragms were usually reconstructed with artificial diaphragm patch because of the extensive resection. PATIENT CONCERNS: We reported a male patient with complaints of dyspnea, chest pain and massive pleural effusion in the left chest detected by chest X-ray. A huge mass of 20 × 20 cm was seen in the left lower chest in the computed tomography (CT) scan. DIAGNOSIS: The diagnosis of MSFT originating in the diaphragm was made by post-operative immunohistochemical examination. INTERVENTIONS: After draining 4000 ml of pleural effusion by Pleurx catheter to relieve the pressure symptom, the patient underwent en-block resection by left posterolateral thoracotomy. A pedicle tumor originating in the left diaphragm was found, which was smooth, lobular, did not invade surrounding tissues or organs, and received blood supply from the left phrenic vessels. The diaphragm was successfully sutured without tension and did not require artificial reconstruction as the defect was small. OUTCOMES: After 2 months follow-up, the left lung was restored to normalcy, and no pleural effusion or new occupying neoplasm was found in follow-up CT.


Assuntos
Diafragma , Tumores Fibrosos Solitários/cirurgia , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/cirurgia , Tumores Fibrosos Solitários/diagnóstico por imagem , Toracotomia , Tomografia Computadorizada por Raios X
8.
Neuroradiology ; 62(2): 175-184, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31673748

RESUMO

PURPOSE: Intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma are difficult to distinguish owing to their overlapping imaging manifestation on routine magnetic resonance imaging. The purpose of this study was to assess whether SFT/HPC can be differentiated from meningioma with diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI). METHODS: We retrospectively reviewed DWI, SWI, conventreional MR, and CT imaging features of 16 patients with SFT/HPC and 96 patients with meningioma. The apparent diffusion coefficient (ADC) value, normalized ADC (nADC) value, and degree of intratumoral susceptibility signal intensity (ITSS) were compared between SFT/HPCs and meningiomas using two-sample t tests, and among SFT/HPCs, low-grade and high-grade meningioma were tested using one-way analysis of variance (ANOVA). Receiver operating characteristic (ROC) curve and logistic regression analyses were performed to determine the differentiation capacity. RESULTS: The ADC value, nADC value, and the degree of ITSS in SFT/HPC were significantly higher than those in low-grade and high-grade meningiomas (all p < 0.05). The threshold value of > 1.15 for nADC provided 75.00% sensitivity and 60.42% specificity for differentiating SFT/HPC from meningioma. Compared with nADC, the degree of ITSS had a moderate sensitivity (62.50%) and a higher specificity (85.42%) using the threshold value of > 1.00. Furthermore, combining DWI and SWI can achieve a relatively high differentiation capacity with a sensitivity of 81.25% and specificity of 78.12%. CONCLUSIONS: The nADC ratios and ITSS are useful for differentiating SFT/HPC from meningioma. Combining ITSS and nADC value appears to be a promising option for differential diagnosis.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Hemangiopericitoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Tumores Fibrosos Solitários/diagnóstico por imagem , Adulto , Idoso , Meios de Contraste , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
13.
Ir Med J ; 112(6): 954, 2019 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-31538443

RESUMO

Introduction Solitary fibrous tumours are rare mesenchymal tumours that most commonly originate from the visceral pleura. Extra-thoracic primary sites including; head and neck, soft tissue, retroperitoneum and the urological tract, are associated with late recurrence. Case We present a case of metastatic pulmonary Solitary Fibrous Tumour presenting 11 years post resection of renal primary Solitary Fibrous Tumour. The patient underwent apical segmentectomy of the right lower lobe extending to wedge excision of right upper lobe due to fissure involvement with lymphadenectomy. The patient was discharged day 12 post surgery. Discussion Robust guidance regarding long-term management of solitary fibrous tumours is lacking. Salvage resection offers favourable long-term prognosis. This case demonstrates the importance of long-term surveillance.


Assuntos
Neoplasias Renais/patologia , Neoplasias Pulmonares/secundário , Pulmão/patologia , Tumores Fibrosos Solitários/secundário , Idoso , Feminino , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Tumores Fibrosos Solitários/diagnóstico por imagem
14.
J Med Case Rep ; 13(1): 246, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31391097

RESUMO

INTRODUCTION: Solitary fibrous tumors are tumors of mesenchymal origin that occur in the extremities and occasionally in pleura, meninges, and so on, but are extremely rare in the adrenal gland. Their biological behavior is variable but mostly benign. CASE PRESENTATION: A 13-year-old Oromo girl presented with a progressively increasing right upper abdominal mass of 3 years' duration. She had dull dragging pain and an occasional low-grade fever. On examination she had 20 × 20 cm mass with well-defined medial and inferior border. Both ultrasound and computed tomography scan showed a highly vascularized mass arising from her right adrenal gland but she had neither the constitutional symptoms of a functional adrenal tumor nor an abnormal biochemical test. Surgical resection showed a vascularized mass with attachments to the right lobe of the liver with a weight of 1900 g. It was found to be a giant solitary fibrous tumor of her right adrenal gland with infrequent mitosis. She stayed for 5 days after surgery and was discharged. She showed remarkable recovery at follow-up at 3 months. CONCLUSION: Although very rare, solitary fibrous tumor of the adrenal gland should be considered in differential diagnosis of adrenal masses.


Assuntos
Neoplasias das Glândulas Suprarrenais/patologia , Tumores Fibrosos Solitários/patologia , Adolescente , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/cirurgia , Tomografia Computadorizada por Raios X
15.
Med Sci Monit ; 25: 5992-5996, 2019 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-31401642

RESUMO

BACKGROUND To determine if ADC and DCE-MRI can be used to differentiate angiomatous meningiomas (AMs) from solitary fibrous tumors/hemangiopericytomas (SFT/HPCs). MATERIAL AND METHODS We retrospectively reviewed records of 103 patients from 1 January 1 2014 to 1 November 2018. We enrolled 41 patients who had undergone a 3T MRI, with histologically confirmed AMs in 20 (48.80%) patients, and SFT/HPCs in 21 (51.20%) patients. The ADC and DCE-MRI features were derived and then compared by 2 independent-samples t tests and Wilcoxon rank sum test to obtain the ROC. RESULTS AMs had significantly lower ADC values than did SFT/HPCs, but AMs had significantly higher MCER values than did SFT/HPCs. A threshold value of 1.03×10⁻³ mm²/s for ADC to predict AMs from SFT/HPCs was estimated (AUC=0.902, sensitivity=88.20%, specificity=83.30%). Optimal diagnostic performance (AUC=0.825, sensitivity=84.60%, specificity=81.80%) was obtained when setting MCER=226.7% as the threshold value. CONCLUSIONS The ADC values of AMs were lower than those of SFT/HPCs; the MCER of AMs were greater than those of SFT/HPCs, and ADC was more useful than MCER, and these parameters could help diagnosis.


Assuntos
Hemangiopericitoma/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Tumores Fibrosos Solitários/diagnóstico por imagem , China , Meios de Contraste , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Aumento da Imagem/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 98(32): e16743, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393388

RESUMO

RATIONALE: Solitary fibrous tumor(SFT) is a rare and distinct clinical entity. There are few descriptions in the literature regarding the PET manifestations of SFTs. Herein,we report a case of multiple malignant SFT with PET/CT imaging findings and PET/Contrast Enhanced CT image findings. PATIENT CONCERNS: A 30-year-old woman presented with a history of a mass in neck increased gradually over 6 months without jaundice or other symptoms of obstruction.Serum laboratory results and tumor markers (AFP, CEA,CA199,CA724,CA153 and CA125)were normal. The whole body PET/CT scan showed lightly or mildly hypermetabolic and inhomogeneous metabolic which was different from other reports, and it was the first report of 18F-FDG-PET/CT findings of multiple malignant SFTs, which were confirmed by positive immunohistochemical staining for CD2-40, CD99, SMA and negative immunohistochemical staining for S100 and CD34. DIAGNOSES: She was diagnosed with multiple malignant solitary fibrous tumors which was confirmed by pathological results and 18F-FDG-PET/CT findings. INTERVENTIONS: The patient didn't receive any treatment because she was not suitable for surgery and refused any other therapy. OUTCOMES: The patient has been followed up for one year,and she was still alive. LESSONS: SFTs should be detected early and treated early.It was of high value in the diagnosis and differential diagnosis of SFTs by PET/CT imaging findings, which can not only identify the benign and malignant lesions, but also identify the lesion involved range.


Assuntos
Tumores Fibrosos Solitários/diagnóstico , Adulto , Biomarcadores Tumorais , Feminino , Fluordesoxiglucose F18 , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Tumores Fibrosos Solitários/diagnóstico por imagem
17.
Am J Case Rep ; 20: 1205-1209, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31413253

RESUMO

BACKGROUND Tumor-to-tumor metastasis is an uncommon phenomenon in which a primary tumor metastasizes into another tumor. CASE REPORT An 81-year-old Asian woman was referred to our hospital for evaluation and treatment of a solid mass in the right middle lung lobe that had rapidly enlarged for 1.5 years compared to that observed over the last 5 years. On computed tomography (CT), the mass was 68×60 mm, and 2 different tumors appeared to exist in the upper portion of the mass. Blood examination findings revealed high serum levels of progastrin-releasing peptide and neuron-specific enolase. Based on the radiographic course of the tumor and elevated levels of tumor markers, we suspected that a new malignant tumor, such as a neuroendocrine tumor, had developed dorsally adjacent to the benign tumor. CT-guided percutaneous needle biopsy of the lung indicated a solitary fibrous tumor (SFT), which did not lead to the diagnosis of another tumor adjacent to the original tumor. Therefore, a right middle lobectomy was performed. The resected specimen contained 2 different tumors: an SFT and a typical carcinoid without mitosis or necrosis. On microscopic examination, they were separated from each other by normal alveolar tissue. In addition, a typical carcinoid was also observed inside the SFT lesion, completely enclosed by the SFT tissue. These findings suggested that the carcinoid metastasized to the SFT in the same lung lobe. CONCLUSIONS To the best of our knowledge, this is the first case of a pulmonary typical carcinoid metastasizing to an intraparenchymal SFT.


Assuntos
Tumor Carcinoide/patologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/secundário , Tumores Fibrosos Solitários/secundário , Idoso de 80 Anos ou mais , Tumor Carcinoide/diagnóstico por imagem , Feminino , Humanos , Biópsia Guiada por Imagem , Neoplasias Pulmonares/diagnóstico por imagem , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/patologia , Tomografia Computadorizada por Raios X
20.
Acta Neurochir (Wien) ; 161(9): 1937-1942, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31300885

RESUMO

BACKGROUND: Large tumors arising from the middle scalene region can displace the middle scalene muscle and distort regional anatomy, placing nerves at risk. Understanding the surgical anatomy of these nerves is key to approaching pathology of the middle scalene muscle and avoiding damage to the dorsal scapular, long thoracic, and spinal accessory nerves, each of which can cause scapular winging and associated morbidity if injured. METHODS: IRB approval was obtained for this study, allowing cases with relevant pathology to be reviewed and presented to highlight the relevant surgical technique. Anatomical depictions were created to correlate intraoperative images with known anatomical relationships. RESULTS: Key to this approach is consideration of the regional anatomy in a standard supraclavicular approach, the superficial plane, containing the anterior scalene muscle and brachial plexus, and the oblique plane containing the middle scalene muscle, long thoracic, spinal accessory, and dorsal scapular nerves. Identification and mobilization of each of these structures prior to lesion removal can not only provide likely boundaries of the tumor, but also allow for protection of the nerves to avoid injury that may lead to scapular winging with associated morbidity and functional impairment of the upper extremity. CONCLUSIONS: Lesions of the middle scalene region often split two important anatomical planes, the superficial and deep, creating an advantageous surgical corridor through an anterolateral approach. Through early identification of known anatomy, these two planes can be developed, and a safe approach to the lesion of the middle scalene region can be exploited.


Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Músculos do Pescoço/lesões , Músculos do Pescoço/cirurgia , Procedimentos Neurocirúrgicos/efeitos adversos , Escápula/lesões , Eletromiografia , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/etiologia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Músculos do Pescoço/anatomia & histologia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Tumores Fibrosos Solitários/diagnóstico por imagem , Tumores Fibrosos Solitários/cirurgia , Resultado do Tratamento
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